Abstract Sensory disorders such as hearing, visual, and olfactory impairments have been demonstrated to be associated with cognitive decline in older adults although these associations are complex and can exhibit bidirectionality. A recent studies on these leading sensory disorders often serve as risk factors and the earliest manifestations of many neurological diseases such as Alzheimer?s diseases. Community based studies of multiple sensory impairments enable investigators to examine the relative importance of each system component as it related to risk of cognitive decline. There is a need for sensitive tests for the detection of mild cognitive impairment (MCI) that are easy to administer in clinical settings and which can be incorporated into longitudinal population-based studies. The Loewenstein-Acevedo Scale for Semantic Interference and Learning (LASSI-L) cognitive stress test is such a validated measure designed to detect MCI and can be administered in less than 15 minutes developed by Co-I Dr. Loewenstein?s group. The LASSI-L has also been shown to be validated for use in Hispanic populations, is available in Spanish, and has exhibited utility in African-American populations. This administrative supplemental funding request is designed to add the LASSI-L and a sensory impairment test battery to our ongoing translational R01 which is studying the genetic basis of age-related hearing loss. This proposal leverages the exceptional multidisciplinary expertise of collaborators at UM to identify and refine a sensory impairment battery for the early detection of MCI that can be incorporated into population-based aging studies. Co-investigators include Drs Cejas (clinical psychologist), Lee (epidemiologist), and Blanton (population geneticist) who have served as Co-Is in the parental R01 and Dr. Loewenstein who is an expert in investigating novel cognitive and functional measures for the early detection of Alzheimer?s disease (AD) and other cognitive disorders of aging, cross-cultural assessment. We have already established a sensory disorders clinic associated in conjunction with this project and have the capability to see 180 age-eligible patients of diverse racial background on a weekly basis who will be screened using the LASSI-L to identify those with and without MCI. Age- and gender matching will be employed to establish 30 participants with and without MCI in 3 defined race- ethnic groups: Blacks, Hispanics, and non-Hispanic whites. These 180 patients will then be administered the sensory impairment battery. In this supplemental application, we will build on our accomplishments and preliminary data by proposing to complete the three specific aims. Specific aims include: Aim1- Administer the LASSI-L to 180 participants in the parent R01 to establish a cross-section of those with and without MCI in three defined race-ethnic subgroups. Aim2- Administer a sensory impairment battery to selected participants and conduct analyses to determine which combination of impairments discriminate between those with and without MCI. Aim 3? Examine the relationship between ApoE and cognitive decline leading to Alzheimer Disease in patients with various degrees of hearing loss. These findings will establish that the LASSI- L can be effectively administered in a clinic setting and will enable us to take the first steps to identify and refine a sensory impairment battery for the early detection of MCI that can be incorporated into population-based aging studies.